View source for Focal neurologic deficits

==Background==
*Also known as focal neurologic signs 
*Refer to objective abnormalities of a specific region of the body detected on the neurologic examination

==Focal Neurologic Signs Organized by Region==
===Brain===
*'''Frontal Lobe''' 
**Damage to the frontal lobe can lead to the following signs:
***[[Numbness|Sensory]]/[[weakness|motor]] deficit of the contralateral lower extremity
***Language disturbances
***Profound behavioral changes
***Indifference, apathy
***Disinhibition (labile and irritable)
***Impaired judgement, decreased social graces
***Akinesia (lack of spontaneous movements)
***Impairment of memory
*'''Parietal Lobe''' 
**Damage to the parietal lobe can lead to the following signs:
***Agnosia
***Anosognosia – Unawareness of a deficit
***Unilateral spatial neglect (hemineglect) 
***Dyslexia, dysgraphia, dyscalculia
***Impairment of tactile sensation

*'''Temporal Lobe''' 
**Damage to the temporal lobe can lead to the following signs:
***Upper homonymous quadrantanopsia
***Cortical [[hearing loss|deafness]]
***Wernicke’s aphasia (word deafness, auditory verbal agnosia)
***[[Hallucinations]]
***Complex partial [[seizures]]
***Kluver-Bucy syndrome (Bilateral disease. Compulsion to attend all visual stimuli, hyperorality, hypersexuality, blunted emotional reactivity)

*'''Occipital Lobe'''
**Damage to the temporal lobe can lead to the following signs:
***Contralateral homonymous hemianopia
***Cortical [[vision loss|blindness]] (bilateral lesions)
***Visual [[hallucinations]]
***Prosopagnosia
***Alexia without agraphia
***Loss of topographic memory and visual orientation

*'''Limbic System'''
**Damage to the limbic system can lead to the following signs:
***Retrograde amnesia (long-term memory loss)
***Anterograde amnesia (inability to form new memories)
***Apathy
***Loss of olfactory functions
***Cerebellar
***Damage to the cerebellum can lead to the following signs:
***[[Ataxia]] of voluntary movements
***Intention [[tremor]]
***[[Dysarthria]] 
***Postural abnormalities
***Hypotonia
***Incoordination
***[[Nystagmus]], gaze paresis

*'''Brainstem'''
**Damage to the brainstem can lead to the following signs:
***Crossed deficits – [[weakness|motor]] or [[numbness|sensory]] involvement of the face on one side of the body and the arm and leg on the other side 
***[[Cranial nerve]] palsies (see below)

{{Cranial nerve deficits}}

{{Spinal cord syndromes DDX}}

{{Peripheral nerve syndromes}}

==Evaluation==
[[File:Spinal cord tracts.svg|thumb|Spinal cord tracts]]
[[File:Dermatomes and cutaneous nerves - anterior.png|thumb|Dermatomes and cutaneous nerves - anterior]]
[[File:Dermatomes and cutaneous nerves - posterior.png|thumb|Dermatomes and cutaneous nerves - posterior]]
[[File:Cutaneous innervation of the upper limb.svg|thumb|Cutaneous innervation of the upper limb]]
[[File:Lower limb peripheral innervation.png|thumb|Lower limb peripheral innervation]]
*Rule out acute causes of focal neurologic signs: [[Stroke (main)|stroke]], [[hemorrhagic stroke]], [[intracranial hemorrhage]], [[meningitis]]

==Management==
*Treat underlying condition

==Disposition==
*Depending on cause

==See Also==
*[[Stroke]]
*[[Peripheral nerve syndromes]]
*[[Epidural compression syndromes]]
*[[Upper extremity peripheral innervation]]

==References==
<references/>
#LeBlond RF, Brown DD, Suneja M, Szot JF. LeBlond R.F., Brown D.D., Suneja M, Szot J.F. LeBlond, Richard F., et al. DeGowin’s Diagnostic Examination, 10e. New York, NY: McGraw-Hill; 2015. http://accessmedicine.mhmedical.com.foyer.swmed.edu/content.aspx?bookid=1192&Sectionid=68670445. Accessed September 11, 2015. 
#Waxman SG. Clinical Neuroanatomy, 27e. New York, NY: McGraw-Hill; 2013. http://accessmedicine.mhmedical.com.foyer.swmed.edu/content.aspx?bookid=673&Sectionid=45395961. Accessed September 07, 2015.
#Ropper AH, Samuels MA, Klein JP. Adams & Victor's Principles of Neurology, 10e. New York, NY: McGraw-Hill; 2014. http://accessmedicine.mhmedical.com.foyer.swmed.edu/content.aspx?bookid=690&Sectionid=50910870. Accessed September 07, 2015.
#Aminoff MJ, Greenberg DA, Simon RP. Disorders of Equilibrium. In: Aminoff MJ, Greenberg DA, Simon RP. eds. Clinical Neurology, 9e. New York, NY: McGraw-Hill; 2015. http://accessmedicine.mhmedical.com.foyer.swmed.edu/content.aspx?bookid=1194&Sectionid=68656660. Accessed September 08, 2015.
#Stone C, Humphries RL. eds. CURRENT Diagnosis & Treatment Emergency Medicine, 7e. New York, NY: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com.foyer.swmed.edu/content.aspx?bookid=385&Sectionid=40357242. Accessed September 15, 2015.

[[Category:Neurology]]
[[Category:Symptoms]]